Academic journal article Journal of Cognitive Psychotherapy

To Defend or Not to Defend: A Comparison of Paranoia and Depression

Academic journal article Journal of Cognitive Psychotherapy

To Defend or Not to Defend: A Comparison of Paranoia and Depression

Article excerpt

Research exploring inferential, especially attributional, thinking supports the theory that paranoia is a defense against low self-esteem. The present study extends this research by examining the place of evaluative beliefs in paranoia and depression. In particular, the study begins to explore the possibility that the defensive function of paranoia is to prevent perceived negative other-self evaluation becoming self-self, as happens in depression, by discrediting others through negative self-other evaluations. A paranoid group (n = 23) a depressive group (n = 22) and a normal control group of (n = 22) are compared on their responses to the Beck Depression Inventory and the Evaluative Beliefs Scale, an 18-item measure of other-self, self-self and self-other negative person evaluations. Results supported and refined this theory. As expected, subjects in both clinical groups perceive significantly more negative other-self evaluation (i.e., threat) than controls, with scores significantly higher for the depressed group. Negative self-self evaluation was highest in the depressives; the paranoid group scores were significantly higher than controls, perhaps implying that the paranoid defense is only partial. Lastly, negative self-other evaluations were significantly higher in the paranoid group; the depressives and controls did not differ.

The theory that paranoia is a defense against low self-esteem has a long history. Zigler and Glick (1988) argue that it is delusions of persecution, the core feature of paranoia, which assuage a sense of personal inadequacy in two ways. First, they allow the projection of responsibility for personal inadequacy on to others, and second, they confer a personal importance.

The first of these ideas has received substantial recent empirical support. In an important series of empirical studies, Bentall and colleagues (see Bentall, Kinderman, & Kaney, 1994) have shown that people with paranoid delusions show an exaggerated form of the self-serving bias (Miller & Ross, 1975)-that is, an ordinary defensive tendency to attribute responsibility for failure externally and success internally, and thereby maintain self-esteem. This is in contrast to people with depression, who show the reverse attributional pattern (Peterson & Seligman, 1984) and therefore have low self-esteem. Furthermore, when an indirect measure of attributional thinking is used, the Pragmatic Inference Test, individuals with paranoia are found to show a depressive style of thinking; this is consistent with the idea that underlying paranoia is low self-esteem (see Bentall et al., 1994). The second of Zigler and Click's observations about the defensive properties of persecutory delusions is consistent with the commonly reported finding that paranoid people, although usually depressed, have high self-esteem.

Hitherto research has concentrated on drawing out the nature of the inferential, especially attributional, thinking in paranoia. The present study begins to consider the place of evaluative thinking in paranoia. One of the main tenets of cognitive psychotherapy has long been that negative evaluations are functionally associated with emotional distress (e.g., Arnold, 1960; Beck, 1976; Ellis, 1962)-a position that has both theoretical and empirical support (Lazarus, 1989; Smith, Haynes, Lazarus, & Pope, 1993). Indeed, Ellis even goes so far as to suggest that it is only evaluations, and not inferences, which provoke emotional problems. An evaluation or "hot" cognition may be defined as a good-bad judgment, or a preference as opposed to an inference (Zajonc, 1980) and aperson evaluation as an evaluation of either oneself or another person. Negative person evaluations are defined as stable, global and total condemnations of the entire person and may be attributed in three directions: "other-self where the other is making an evaluation of me, "self-self" where I evaluate myself, and "self-other" where I evaluate the other (Trower, Casey, & Dryden, 1988). …

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